Women,Aging, and Schizophrenia

SUMMARY

Schizophrenia is a psychiatric disorder of unknown etiology that typically has an onset in early adulthood and persists for the remainder of the life span. For most affected individuals, the illness is recurrent with psychotic symptoms that tend to be episodic in nature. The illness has pervasive and disruptive effects on many life domains; for example, women with schizophrenia are less likely to marry, bear children, and raise their own children than are women in the general population. The age of onset of schizophrenia is later on average in women than men, and women are overrepresented among those who develop the illness after the age of 45. Among younger patients with schizophrenia, women tend to have less severe symptoms than men and better outcomes; however, there are fewer gender differences among older patients with schizophrenia. Older women with schizophrenia are vulnerable to problems of both schizophrenia and aging. Schizophrenia symptoms typically continue in later years and include ongoing psychotic symptoms. Problems of aging such as cognitive decline and chronic medical conditions may be exacerbated by schizophrenia and the disorder is associated with premature mortality. Older women with schizophrenia are at risk for neglect of psychiatric and other health needs that are further compounded by limited social support and low socioeconomic status. More research and clinical attention is needed for the problems of older women with schizophrenia.     

Older women and family care in Hong Kong: differences in filial expectation and practices

Cultural aspects of aging have great importance on how older women and men are being treated, in particular in Asia where patriarchal practices dominate. Further, changes in the structure of the Chinese family alter this supportive function, and changes in traditional values affect the nature of the care and support provided to older women and men. This proposition was investigated by a quantitative study involving a survey of 390 older persons in Hong Kong. There are great discrepancies in informal support for older women and men. Older women are less likely to live with adult children; more likely to need financial assistance; and more likely to receive poor informal support. There is evidence that informal support for the elderly is changing in Hong Kong, and older women are being disadvantaged, experiencing insufficient and unavailability of informal support.     

Caregiving and Care-Receiving:

Many aspects of aging are women's issues. Yet research on aging has, until recently, focussed little attention of gender differences in the experience of growing old. Older women are more likely than older men to be poor, widowed, living alone in poor health, receiving assistance from both formal and informal supports, as well as being institutionalized in long-term care facilities. This secondary analysis of data from the 1982 Survey of the Elderly in the Waterloo Region attempts to address a gap in our knowledge concerning gender differences in the giving and receiving of social support in later years. Gender differences in (1) need for social support, (2) turning to formal assistance, (3) amount of formal assistance used, and (4) amount of informal assistance received were examined using analysis of variance and logistic regression procedures. The profile of social support that emerged suggests both similarities and differences in the way elderly men and women experience the giving and receiving of social support. Older women in this sample were found to be disadvantaged in the areas of income, health, years lived alone, and loneliness, relative to older men. Low-income was related to formal service use for older women, but not for older     

Families,social life,and well-being at older ages

As people age, many aspects of their lives tend to change, including the constellation of people with whom they are connected, their social context, their families, and their health—changes that are often interrelated. Wave I of the National Social Life, Health, and Aging Project (NSHAP) has yielded rich information on intimate ties, especially dyads and families, and on social connections generally. Combined with extensive biological and other health measures, NSHAP enables researchers to address key questions on health and aging. We begin with recent findings on intimate dyads, then move to social participation, and finally to elder mistreatment. Among dyads, we find that whereas sexual activity drops sharply with age for both women and men, gender differences in partner loss as well as psychosocial and normative pressures constrain women’s sex more than men’s. However, surviving partnerships tend to be emotionally and physically satisfying and are marked by relatively frequent sex. In contrast to sex, nonsexual intimacy is highly prevalent at older ages, especially among women. Older adults are also socially resilient—adapting to the loss of social ties by increasing involvement with community and kin networks. Despite these social assets, older adults remain vulnerable to mistreatment. Overall, these findings yield a mixed picture of gender-differentiated vulnerabilities balanced by proactive adaptation and maintenance of social and dyadic assets.     

Stressors,Coping Resources,Functioning, and Role Limitations Among Older Korean Immigrants: Gender Differences

This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.     

Challenging social myths and stereotypes of women and aging: heterosexual women talk about sex

Cultural representations of aging and sexuality combine to paint a particular picture of mid and later life for women: menopause is constructed as a time when women either lose or renew their interest in sex, and later life a time when sexual activity no longer assumes importance yet remains vital to healthy aging. This article examines the importance of sexual activity to "older" women, paying particular attention to how they negotiate such representations. In-depth interviews were conducted with 19 women aged 50 and older recruited from Sheffield, UK. A material-discursive analysis revealed that whilst participants rejected the asexual discourse of aging they accepted it for women older than themselves. They constructed women per se as sexually complex, in comparison to men, making sexual activity "risky business" for women, and positioned their own sexual desire as responsive, either to a man's sexual desire or to their own hormones. Finally, sexual activity was constructed as having psychological and physiological benefits for couples within committed relationships. The findings are discussed in terms of their implications for research, theory and clinical practice.     

Introduction: the need to address older women's mental health issues

Women are the primary consumers of mental health services. Ironically, research addressing their unique needs lags behind that of men's issues. The aging process introduces an important variable that accentuates the relative lack of information and specific treatment guidelines for older women who are confronted by mental health problems. This volume offers a comprehensive overview for the health professional who is seeking a greater depth of understanding with respect to the study of mental health problems in general, and how these issues pertain specifically to women and the aging process. A second goal of this project is to provide the practicing therapist and counselor with a research update and a broad clinical perspective offered by seasoned clinicians. Using current psychiatric diagnosis as a framework, the contributions address the range of mental health problems, including dementia and cognitive impairment, schizophrenia, alcohol abuse, mood and anxiety disorders, traumatic and dissociative conditions, sexual and eating disorders, and personality disorders. It is hoped that this book will inform, inspire and encourage students and health professionals in their work with middle aged and older women who are facing mental health challenges.     

Older adults in sub-Saharan Africa living with children and grandchildren

Using data from Demographic and Health Surveys, we examine the composition of households containing older adults in 24 countries of sub-Saharan Africa, with a focus on those living with children and grandchildren. Overall, 59 per cent live with a child and 46 per cent with a grandchild. Men are more likely to live in nuclear households and women in extended households and alone. Regression analyses show that individual-level determinants of household composition differ by sex. For example, living with children and grandchildren is tied to living with a spouse for men, but for women the effect is either not significant or in the opposite direction. Households with an older adult and a grandchild, but no adult children, are common. Usually the adult child lives elsewhere, though about 8 per cent of older adults live with a grandchild who has at least one deceased parent. Older adults are more likely to be living with double-orphans in countries with high AIDS-related mortality.     

Is social engagement linked to body image and depression among aging women?

Maintaining an active and engaged social life is a critical component of aging well, and women are generally more socially active than men. However, as women age their self-perceptions of their bodies may reduce social behaviors and consequently, increase depressive symptoms. Because little is known about how body image is associated with social engagement and depressive symptoms among aging women, four aspects of body image: satisfaction with cosmetic features, body function, physical appearance, and weight were assessed among women aged 65 and older (n = 123). Regression analyses indicated that cosmetic appearance, body function, and physical appearance were associated with depressive symptoms, whereas satisfaction with weight was unrelated. Further, both greater satisfaction with cosmetic features and body function were associated with higher levels of social engagement, and social engagement mediated the association between these aspects of body satisfaction and depressive symptoms. The findings indicate that specific age-relevant aspects of body satisfaction are linked to social behavior and depression among aging women, and reduced body satisfaction may lead to lower social engagement, and consequently aging women’s health and well-being may be diminished.     

The importance of fairness and equity for the marital satisfaction of older women

In all societies, people are concerned with social justice. "It's just not right" is a fairly common lament. In these two studies, we interviewed 240 older women, who ranged in age from 50 to 82. We found that most older women (85%) considered their marriages to be fair and equitable. Older women were less concerned about existing inequities than their younger peers. Nonetheless, they were somewhat concerned with how rewarding and how fair and equitable their relationships were perceived to be. Those who felt over-benefited, for example, felt more guilty than did their less advantaged peers; those who felt under-benefited felt far more angry than did their privileged peers. Stressful life events--such as the arrival of children, retirement, serious illness, or the awareness impending death--often brought to awareness long simmering resentments over issues of fairness.     

Aging of Indian Women in India: The Experience of Older Women in Formal Care Homes

The feminization of aging is a process that has begun in India but is not occurring uniformly throughout India. Older women are more likely to be widowed, poor, and suffer vulnerability to adverse outcomes like poor health. With the changing social landscape of India, middle-income older women are increasingly opting for ‘pay and stay homes’, an emerging type of old age home in India. Majority of the 97 women residents of ‘pay and stay’ homes reported being widowed (68%), and 25% were childless. Childlessness and widowhood were important considerations in the decision to relocate to an old age home. Older women reported higher degrees of psychological closeness and contact with daughters than sons, and the overall social network size was small. High prevalence of diabetes rates among older women carries implications for potential functional disability. Strong advocacy measures for empowering older women in India should be a priority policy directive.     

Differences in disability among older women and men in Egypt and Tunisia

Research on child survival and health has indicated disparities between boys and girls in selected Middle Eastern countries. Health disparities in later life are understudied in this region. In this article, we examine differences between women and men in later-life activity limitation in Egypt and Tunisia. Difficulty executing physical tasks is more common for women than for men in both study sites, although differences are smaller after adjustment for underlying illness. Differences in the difficulty of executing physical tasks also are sensitive to environmental controls in variable ways across the study sites. The findings caution against the sole use of reported disability in comparative studies of gender and aging.     

Probability of marriage and fertility of women suffering from schizophrenia or affective disorders

Abstract Schizophrenia and affective disorders are the main forms of severe mental illness among women of childbearing age; earlier this century European and American studies showed that the fertility of these patients was reduced. Since the second world war the development of community-orientated psychiatry appears to have resulted in a lessening of differentials between patients and normal women. The present study was designed to estimate probability of marriage and fertility of such patients in London followingthese developments in psychiatry. Over 1,000women aged 16-50 were selected from 1955-63 admissions to a London hospital, and data were collected from medical records. Owing to the demographic heterogeneity of the sample, the analysis of maximum discriminative power was to compare each patient with a normal woman of corresponding age, observed during identical calendar periods, as derived from Registrar General's estimates. The fertility of each patient was compared with that of a normal woman, controlled for age at and duration of marriage, and an assessment was made of the effect of hospital stay on fertility. Before admission, probability of marriage of schizophrenics was just under three-quarters of that of normal women, and after admission this was greatly reduced to just over one-third of normal; women with affective disorders were very similar to normal women as regards probability of marriage, and also fertility. The fertility of schizophrenics was reduced both before and after admission, and much of the latter reduction depended on the effect of hospital stay; however, this fertility differential was too small to be clinically or socially important. The relevance of these results to the population genetics of schizophrenia is noted. Affective disorders are primarily disorders of mood, usually involving a depression, but in a smaller group of patients periods of excitement or elation involving marked overactivity of thought and behaviour. The patient may return to normal between these periods of illness, and although delusions and hallucinations sometimes occur they are usually less prominent than in schizophrenia. Affective disorders generally become evident later in life than schizophrenia, and they often require shorter periods of in-patient treatment, and the medical prognosis is often more hopeful. The expectation of affective psychoses (the most severe forms of the disorder) for a member of the general population varies between 0·3 and 1% from country to country. Milder conditions have also been included in this study, and the expectation of all these affective disorders is likely to be much higher.     

The Importance of Fairness and Equity for the Marital Satisfaction of Older Women

ABSTRACT

In all societies, people are concerned with social justice. “It's just not right” is a fairly common lament. In these two studies, we interviewed 240 older women, who ranged in age from 50 to 82. We found that most older women (85%) considered their marriages to be fair and equitable. Older women were less concerned about existing inequities than their younger peers. Nonetheless, they were somewhat concerned with how rewarding and how fair and equitable their relationships were perceived to be. Those who felt over-benefited, for example, felt more guilty than did their less advantaged peers; those who felt under-benefited felt far more angry than did their privileged peers. Stressful life events—such as the arrival of children, retirement, serious illness, or the awareness impending death—often brought to awareness long simmering resentments over issues of fairness.     

Forever young: Visual representations of gender and age in online dating sites for older adults

ABSTRACT

Online dating has become increasingly popular among older adults following broader social media adoption patterns. The current study examined the visual representations of people on 39 dating sites intended for the older population, with a particular focus on the visualization of the intersection between age and gender. All 39 dating sites for older adults were located through the Google search engine. Visual thematic analysis was performed with reference to general, non-age-related signs (e.g., facial expression, skin color), signs of aging (e.g., perceived age, wrinkles), relational features (e.g., proximity between individuals), and additional features such as number of people presented. The visual analysis in the present study revealed a clear intersection between ageism and sexism in the presentation of older adults. The majority of men and women were smiling and had a fair complexion, with light eye color and perceived age of younger than 60. Older women were presented as younger and wore more cosmetics as compared with older men. The present study stresses the social regulation of sexuality, as only heterosexual couples were presented. The narrow representation of older adults and the anti-aging messages portrayed in the pictures convey that love, intimacy, and sexual activity are for older adults who are “forever young.”     

Going solo: Findings from a survey of women aging without a partner and who do not have children

Greater longevity in the UK population has led to the increasing diversity of women experiencing aging in a multitude of ways. Internationally, gender inequalities in aging are still relatively invisible within both government policy and everyday life for particular groups of women. This article explores the concept of women growing older “solo”—by which we mean women who find themselves nonpartnered and aging without children as they move into later life. We report on the findings from a mixed-methods survey of 76 solo women in the UK aged 50 years and over, used to provide a broader overview of the issues and challenges they face as they move into later life. Qualitative data from the survey captured respondents’ perspectives about the links between their relationships status and well-being in later life and highlighted specific cumulative disadvantages emerging for some women as a result of their solo lifestyles. We discuss two key themes that were identified, “solo-loneliness” and “meaningful futures,” in conjunction with the relevant literature and make suggestions for future research within gender and aging studies that could enhance more positive approaches to solo lifestyles.